Individual provider Active NPI

Courtney Hindsley, PA-C

  • Surgical Physician Assistant
  • Kingsport, TN
National Provider Identifier
1356914014
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4748 Issued in TN
Practice address
130 W Ravine Rd Ste 3a
Kingsport, TN 37660-3841
Phone
(423) 224-4000
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4748 TN Primary
Physician Assistant 363A00000X 4748 TN
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

130 W Ravine Rd Ste 3a
Kingsport, TN 37660-3841

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

111 W Stone Dr Ste 310
Kingsport, TN 37660-6030
Phone (423) 398-7020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, WI, OH3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20211101002592 TN Practitioner - Physician Assistant 8325436900 Reassigns benefits to 1 organization
I20250729002003 WI Practitioner - Physician Assistant 8325436900 Reassigns benefits to 2 organizations
I20251222002866 OH Practitioner - Physician Assistant 8325436900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lima Memorial Professional CorporationGroup PAC ID 1254232184, 167 clinicians
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575

111 W Stone Dr
Kingsport, TN 37660-6027

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 230-8200

Hospital & facility affiliations

  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4748TNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Professional Corporation CurrentSince Nov 26, 2025 Accepting new patients
Lima Memorial Professional Corporation CurrentSince Nov 26, 2025 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 17, 2025 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 17, 2025 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Blue Ridge Medical Management Corporation Physician Assistant Past Accepting new patients
Lima Memorial Professional Corporation Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

L3982
Columbus, OH 43260

1003 Bellefontaine Ave
Ste 125
Lima, OH 45804
Phone (419) 998-8207

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

130 W Ravine Rd
Ste 3A
Kingsport, TN 37660
Phone (423) 224-3220

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

111 W Stone Dr
Ste 310
Kingsport, TN 37660
Phone (423) 398-7020

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1356914014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111",
            "fax_number": "423-282-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD STE 3A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603841",
            "telephone_number": "423-224-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 W Stone Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376606030",
            "country_code": "US",
            "telephone_number": "423-398-7020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINDSLEY",
        "first_name": "COURTNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "4748",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4748",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.